PROJECT SUMMARY/ABSTRACT This resubmission of a competitive renewal application for NIOSH PAR-18-812, addresses the NORA sector Healthcare and Social Assistance and NORA cross-sectors: 1) musculoskeletal health, 2) respiratory health, 3) infectious disease prevention, and 4) traumatic injury prevention. The long-term goal of the study is to protect the occupational safety and health (OSH) of home care (HC) aides. Due to the rapidly aging population, HC aide jobs are among the fastest growing occupations. There is increasing evidence that aides experience many serious OSH hazards to which they are particularly vulnerable because they are low-wage workers and yet there are few HC OSH intervention studies. A major challenge for HC OSH is that the employer has limited control over the work environment because it is a home. To address these challenges, the proposed intervention study will engage HC employers and case managers (CMs), clients and their families, in changing the home-work environment to reduce hazards for HC aides. The overall objectives are to evaluate the effectiveness of interventions and the implementation process and to translate findings to reduce OSH hazards, illness, and injuries among HC aides. The study builds on a highly productive, multidisciplinary research team working with an extensive, active industry-labor-public health-elder services partnership network. Central hypotheses are a) HC aide OSH hazards can be reduced by clients and families with assistance and tools from HC employers and CMs introduced during a client?s home assessment; and b) the interventions will lead to fewer OSH hazards to HC aides. Mixed methods with a research-to-practice (r2p) approach will be used to accomplish specific aims to: 1) Develop OSH interventions and an implementation process to reduce OSH hazards to HC aides; 2) Evaluate the extent to which changes in the home environment by HC clients can reduce the OSH hazards of the aides who visit them by: 2a) implementing OSH hazard interventions and 2b) evaluating the interventions? effectiveness; 3) Evaluate the intervention implementation process; and 4) Translate and disseminate findings via the HC partners. The approach is innovative because it aligns aide and HC client safety; targets a new, potentially powerful leverage point for HC OSH interventions; and seeks to expand OSH into the delivery of elder HC services. It is significant because it aims to reduce OSH hazards, injuries and illnesses among HC aides, a large, low-wage workforce. OSH hazards are also increasingly becoming a burden on HC employers. Expected outputs: evidence-based interventions consisting of activities, tools, and training to reduce OSH hazards for HC aides; lessons learned about how to engage HC clients and families in aide OSH. Expected outcomes- immediate: a reduction in HC aide OSH hazards; intermediate: increased awareness of aide OSH preventive measures among HC clients; incorporation of HC aide OSH in elder services and policies; new knowledge in OSH community about effective HC interventions. Long-term: a healthier, more stable HC workforce to care for our aging population.